• J. Heart Lung Transplant. · Nov 2010

    Bronchoalveolar lavage neutrophilia in acute lung allograft rejection and lymphocytic bronchiolitis.

    • Robin Vos, Bart M Vanaudenaerde, Stijn E Verleden, Stéphanie I De Vleeschauwer, Anna Willems-Widyastuti, Dirk E Van Raemdonck, Lieven J Dupont, Tim S Nawrot, Erik K Verbeken, and Geert M Verleden.
    • Laboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, 49 Herestraat, Leuven, Belgium.
    • J. Heart Lung Transplant. 2010 Nov 1; 29 (11): 1259-69.

    BackgroundAcute cellular rejection and lymphocytic bronchiolitis can impair allograft function after lung transplant (LTx). Both may be refractory to corticosteroid treatment. We hypothesized that bronchoalveolar lavage (BAL) neutrophilia may be increased in either acute rejection or lymphocytic bronchiolitis or may increase with increasing histologic severity.MethodsAll consecutive BAL with subsequent transbronchial biopsy (TBB) specimens, performed in 339 LTx recipients from 2001 to 2008, were retrospectively analyzed. TBB specimens were classified according to histologic grade with analysis of BAL total cell count and cell differentials.ResultsThe analysis included 768 TBB specimens. After adjustment for possible confounders, BAL total cell count significantly increased both with grade A or B severity (p < 0.0001). A higher A grade was characterized by a significant increase in BAL lymphocytosis and neutrophilia (p < 0.0001), whereas for higher B grades, only a more prominent BAL neutrophilia was seen (p < 0.0001).ConclusionsHigher grade A, but, particularly, higher grade B severity scores are characterized by increased BAL neutrophilia.Copyright © 2010 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

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